There have been and will continue to be many preventable deaths in Africa as governments fight to create equity in their budgets and push to make health a priority. Health budgets have historically suffered from severe underfunding and understaffing, resulting not only in deaths but in the suffering of people with illnesses and diseases because they cannot access Health care.
It is under these circumstances that at the dawn of 2020, health departments in 54 African countries were, “as normal as they were”, and had to stretch staff, treatment facilities and medicines. to meet the demands of the population. The arrival of the COVID-19 pandemic has shaken the whole world, including Africa, and its 1.4 billion inhabitants. Already underfunded health budgets sagged and nearly collapsed. Budgets were redefined and health services strengthened, but the consequence was the abrupt closure of medical facilities for “ordinary” health care. As is the norm, Africa has been bailed out with massive loans and grants by the international community; its unfair practices towards developing countries will continue to cripple already “fragile” economies.
The African Development Bank has set up a $10 billion COVID-19 Response Facility to help mitigate macroeconomic “shocks” for African countries. The Bank also announced a $3 billion social bond to support its COVID-19 financing efforts. While this has provided some respite, the next hurdle to overcome is rebuilding post-lockdown economies and finding enough money for COVID-19 vaccines.
Unfortunately, the lion’s share of many countries’ budgets goes to much-needed transportation, security, and water programs. The Africa CDC (Centers for Disease Control and Prevention) says the continent’s limited health budget, weak health facilities and shortage of health workers are a hindrance to the fight against pandemics in general. A shocking accusation is that only 50% of African Union member states have modern health facilities. Around 10% of GDP is spent on health care for most African countries. Many health budgets are supplemented by organizations, both public and private. While the intentions are good, funding is often not aligned with government priorities. In a ‘slap in the face’ to Africans, funding is often only accessible if the money is used in accordance with the donor’s programs.
In my humble opinion, what the continent needs is basic food and medicine for the chronic diseases that we all hate. Nutritious and inexpensive food; and affordable and effective medicines are what this great continent needs. Africa has the highest incidences of maternal and infant mortality in the world, of any continent.
Of grave significance is what happened while COVID-19 was being treated. Other health care programs came to a screeching halt. Some of these included antenatal care, HIV, TB, family planning, and regular routine vaccinations.
Africa, already drowning in debt, is now facing COVID-19 debt which has not been easy due to our past borrowing and repayment practices. And in a cruel twist, prolonged post-COVID treatment may be needed for many thousands of people, many of whom are left debilitated; a direct link to the aftermath of COVID.
Africa has faced many battles, and it has the scars to prove it, and yet every time it thinks it’s gotten away with it, another battle emerges. A vicious circle that will even be difficult for some EU member countries.
However, state governments in the Collaborative Africa Budget Reform Initiative (CABRI) need to reprioritize carefully, with foresight and in good time. They think it could benefit entire economies.
Governments should engage on health budgets at high levels, such as the African Union, and also mandate their members of the Pan-African Parliament to lobby to brainstorm and conceptualize ideas that could change the face of health care. Health budgets must be increased, but new ways must be found to ensure that the money is spent where it is needed, what it needs and when it is needed. This can only happen if there are transparent processes and accountability. A win would be for donors to be engaged so that they are aligned with government health programs.
It is imperative to remind African countries and the international community of two things. First, African countries must continue to focus on strengthening their health systems as a whole. Although slow, progress has been made in this area. The goal of universal health coverage is gaining momentum in Africa, often backed by high-level political will. In this context, more harm than good could come from diverting large amounts of funding through ad hoc channels that may not be efficient or cost-effective (and which may also offer opportunities for corruption) while circumventing enforcement mechanisms. long-term health systems. term.
Second, we need to reconfigure international healthcare cooperation more broadly. A global financing mechanism that serves as a transnational instrument to respond to health crises and also subsidizes health systems between countries at different levels of development is a promising avenue. But the problems facing health systems in developing countries are more important than financing and go beyond the health sector. Issues such as trade imbalances (African countries often need to purchase medicines and medical equipment from international markets but lack the necessary foreign exchange to do so), loss of health workers through migration, capital flight and corruption are all constraints to health care provision and delivery in the poorest countries. These challenges are interrelated and can only be resolved through a different set of global governance mechanisms than the one that exists today.
So what can we do in the short term? To reduce the spread of the virus, many African countries quickly implemented containment measures even when confirmed cases were very low. However, confinement and social distancing will be difficult to maintain, especially in countries without scalable social protection systems. The majority of workers across the continent operate in the informal sector and many survive on what they earn each day through face-to-face transactions.
Let’s all wake up and smell the roses because… A A HEALTHY NATION IS A RICH NATION!
Dr. Michael K. Obeng
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